Acute renal failure

Introduction

Acute renal failure is a rapid decline in renal ability to purify the blood of harmful substances, leading to accumulation of metabolic wastes in the blood such as urea.

The main causes of acute renal failure 

Insufficient supply of blood, kidney

• Not enough blood because of blood loss, dehydration, or physical injury that blocks a blood vessel

• The heart pumps too little (heart failure)

• Extremely low blood pressure (shock)

• Liver failure (hepatorenal syndrome)

Blocked (obstructed) urine flow

• Increased prostate

• Pressure on the urinary tract tumors

Injury within the kidney

• Allergic reactions (eg, radiographic contrast media)

• Toxic substances (toxins)

• Conditions that affect the filtration units (nephrons) renal

• Blocked arteries or veins within the kidney

• Crystals, proteins or other substances in the kidneys

Acute renal failure may result from any condition that reduces the renal blood supply, preventing the flow of urine from the kidneys after a leak, or injury results from the kidneys themselves. Toxic substances can damage the kidneys. Toxic substances such as drugs, toxins, crystals that are deposited in the urine and antibodies that react against the kidney.

Symptoms and diagnosis

Symptoms depend on the severity of renal failure, progression rate and the underlying cause.

The condition that leads to kidney injury often causes severe symptoms that are associated with the kidneys, for example. high temperature, shock, heart failure and liver failure may occur before kidney failure and be more severe than any symptoms of kidney failure, for example. Wegener granulomatosis, which damages the blood vessels in the kidneys can also damage blood vessels in the lungs and cause coughing blood. Skin rash is typical of some forms of acute renal failure, including polyarteritis, SLE (systemic lupus erythematosus) and some toxic drugs.

Hydronephrosis may cause acute renal failure due to obstruction of urine flow. The return of urine into the kidneys causing stretching of space for the collection of urine (renal pelvis), causing convulsions and pain ranging from mild to very severe, usually on one side. About 10% of people have blood in the urine (hematuria).

Doctors should suspect acute renal failure when you reduce the amount of urine secreted. Blood tests to measure levels of creatinine and nitrogen (nitrogen) compounds in the blood (the blood of waste products that are normally cleaned by the kidneys) assist in the diagnosis. The increasing rise in creatinine indicates acute renal failure.

During physical examination, the doctor evaluates the kidneys by determining whether or increased sensitivity. Narrowing of the main renal artery can create the sound (murmur) that can be heard when a stethoscope is placed on the back above the kidneys.

If it is discovered that the bladder is increased, the doctor may put a catheter in order to determine whether replete urine. The flow of urine is obstructed at the exit of the bladder (the opening of the urethra from the bladder), especially in older people. As a result, the bladder and increase urine returns damaging the kidneys. When the expected obstruction (narrowing or blockage) to perform a rectal and vaginal examination to determine whether the formation of some of these areas causes obstruction.

Laboratory tests can help find the cause and degree of renal failure. First, the urine examination. The urine appears normal if kidney failure is a result of inadequate blood supply, or is caused by the difficulty or completely interrupted urine leakage. If the cause of failure is just inside the kidney, urine may contain blood or lumps (cylinders) of red and white blood cells. The urine may contain large amounts of protein (protein) or some type of protein which are normally not found in the urine.

Blood tests revealed abnormally high levels of urea and creatinine, and metabolic imbalance, for example. abnormal acidity (acidosis), high levels of potassium (Hyperkalemia) and low sodium levels (hyponatremia).

It helps show the kidneys with ultrasound or CT. X-ray of kidney (renal) arteries and veins (angiography) can be done if a blockage of blood vessels a possible reason.

MR can be done if deemed too dangerous use of a contrast Rtg. If these tests do not reveal the cause of kidney failure, you need to do a biopsy.

Treatment

Acute renal failure and its immediate complications can often be treated successfully. Survival varies between less than 50% of people who both have multiple organ failure, and 90% of cases are caused by decreased blood flow to the kidneys caused by loss of body fluid bleeding, vomiting or diarrhea.

Careful treatment is necessary to heal the kidneys. Water intake is limited, because it should make up only as much fluid is lost from the body. Weight of patients is measured daily to determine fluid intake.The gain in weight from one day to another indicates excessive fluid intake. With glucose or highly concentrated carbohydrates provide some amino acids (building blocks of proteins) by mouth or intravenously to maintain adequate levels of protein. Since antacids (drugs that neutralize excess stomach acid) containing aluminum bound phosphorus in the gut, may be provided to prevent excessive levels of phosphorus in the blood. Sodium polystyrene sulfonate is sometimes given orally (by mouth) or rectally to reduce high levels of potassium in the blood.

Kidney failure can be so serious as to require dialysis in order to prevent serious damage to other organs and control the symptoms. In these cases, dialysis is started as soon as possible ie after diagnosis. Dialysis can be performed only for the renewal of his kidney function, usually several days to several weeks. On the other hand, if kidneys  are really badly damaged, recovery may be required for all dialysis until a kidney transplant.

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